Background: In Iran, a Middle-East country, no disability scale has been translated and validated for use in stroke clinical trials. This study was designed to translate the Barthel Index and make its Persian translated form valid and reliable. Methods: All items of the Barthel Index were translated into Persian. Also, the Modified Rankin Scale (MRS) was also translated to Persian. Telephone interview was used as the method of data acquisition. Two interviewers were chosen for this means in order to accelerate data gathering and measure interrater agreement. Samples were selected from Isfahan Cardiovascular Research Center’s Stroke Registry Unit, a WHO collaborating center in the center of Iran. All the patients were registered as stroke or intracerebral hemorrhage (ICH). These patients were inhabitants of Isfahan Province who had suffered from stroke or ICH between 12 and 24 months before data acquisition. Chronbach’s alpha, test-retest reliability, concurrent validity with MRS, interrater agreement and item analysis were done for the translated questionnaire. Results: Translated questionnaires were filled by interview from 459 stroke patients. Their mean age was 68.11 ± 11.59 years. 243 of them were male (52.9%). Cronbach’s alpha was 0.9354. Spearman’s correlation coefficient between translated Barthel Index scores and MRS scores was –0.912. Spearman’s correlation coefficient between 2 scores, to determine test-retest reliability was 0.989. Concordance correlation to determine interrater agreement was 0.994. All corrected item–total correlations were greater than 0.5. Conclusions: The Persian translated version of the Barthel Index is a reliable and valid questionnaire for use in stroke clinical trials.

1.
Murray CJL, Lopez AD: Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet 1997;349:1269–1276.
2.
Bonita R, Truelsen T: The WHO STEPwise approach to Stroke Surveillance Overview and Manual. 2. 11-16-0004. Noncommunicable Diseases and Mental Health World Health Organization in collaboration with International Stroke Association.
3.
Sangha H, Lipson D, Foley N, Salter K, Bhogal S, Pohani G, Teasell RW: A comparison of the Barthel Index and the Functional Independence Measure as outcome measures in stroke rehabilitation: patterns of disability scale usage in clinical trials. Int J Rehabil Res 2005;28:135–139.
4.
D’Olhaberriague L, Itvan I, Itsias P, Ansbach HH: A reappraisal of reliability and validity studies in stroke. Stroke 1996;27:2331–2336.
5.
Heuschmann PU, Kolominsky-Rabas PL, Nolte CH, Hunermund G, Ruf HU, Laumeier I, Meyrer R, Alberti T, Rahmann A, Kurth T, Berger K: The reliability of the German version of the BarthelIndex and the development of a postal and telephone version for the application on stroke patients. Fortschr Neurol Psychiatr 2005;73:74–82.
6.
Post MW, van Asbeck FW, van Dijk AJ, Schrijvers AJ: Dutch interview version of the Barthel Index evaluated in patients with spinal cord injuries. Ned Tijdschr Geneeskd 1995;139: 1376–1380.
7.
Norman GR, Streiner DL: Biostatistics the Bare Essentials, ed 2. Hamilton, Decker, 2000.
8.
Zar JH: Biostatistical Analysis, ed 4. New Jersey, Prentice Hall International, 1999.
9.
Kline P: Test construction: factor analytic and item analytic methods; in Kline P (ed): Handbook of Psychological Testing, ed 2. London, Routledge, 2000, pp 161–181.
10.
Nunnally JO: Psychometric Theory. New York, McGraw-Hill, 1978.
11.
Shah S, Vanclay F, Cooper B: Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol 1989;42:703–709.
12.
Sainsbury A, Seebass G, Bansal A, Young JB: Reliability of the Barthel Index when used with older people. Age Ageing 2005;34:228–232.
13.
Hachisuka K, Okazaki T, Ogata H: Self-rating Barthel Index compatible with the original Barthel Index and the Functional Independence Measure motor score. J UOEH 1997;19:107–121.
14.
Sulter G, Steen C, De Keyser J: Use of the Barthel Index and modified Rankin scale in acute stroke trials. Stroke 1999;30:1538–1541.
15.
Korner-Bitenskey N, Wood-Dauphinee S: Barthel Index information elicited over the telephone. Is it reliable? Am J Phys Med Rehabil 1995;74:9–18.
16.
Uyttenboogaart M, Stewart RE, Vroomen PC, De Keyser J, Luijckx GJ: Optimizing cutoff scores for the Barthel Index and the Modified Rankin Scale for Defining Outcome in Acute Stroke. Stroke 2005;36:1984–1987.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.